Despite What TV Tells You, Extreme Makeovers, While Possible, Do Not Occur Overnight
In reality, most complete makeover shows are not completely realistic.
“Many extreme makeover TV programs do not realistically show what is involved in combining multiple plastic surgery procedures,” says Cleveland Clinic-plastic surgeon Frank Papay, MD
“They often make it appear that you are able to combine any number of procedures and fail to show that these are real surgeries with real surgical risks. In an appropriate patient, many surgical procedures can be combined, but this is determined only after a thorough evaluation of the patient’s health and a thorough discussion regarding the true risks and benefits of combining procedures,” he adds.
Makeover shows often gloss over the importance of the physician-patient relationship that is developed during these discussions.
“A good physician-patient relationship is essential to understand the patient’s goals and motivations,” Dr. Papay comments. “Such a relationship allows the plastic surgeon to discuss realistic goals of surgery for that particular patient, the expected postoperative course and the risks and benefits.”
Surgical scars are part of plastic surgery and recovery involves some down time, immobility and swelling. These issues, however, are often far outweighed by the potential gains of the surgery, as long as patients have realistic goals and expectations, Dr. Papay explains. The makeover shows rarely portray the significant amount of time a doctor takes planning the surgery and explaining surgical techniques to the patient, he adds.
For patients in excellent health – without any heart or lung problems or increased risk of blood clots (deep vein thromboses) – Dr. Papay will combine procedures. “A typical patient is a middle-aged woman who has had several children, is near her ideal body weight and comes in unhappy with the changes in her body. We discuss the loose skin and stretched abdominal wall, the little potbelly, perhaps her breast shape. In these patients, it is common to perform a tummy tuck (abdominoplasty) combined with a breast lift or breast enlargement (augmentation) and sometimes liposuction of the flanks to improve their waistline. If she has realistic expectations, she will likely be very happy with her outcome.”
Another increasingly common scenario involves patients who have undergone bariatric surgery and lost massive weight. They have issues with excess skin in the most body areas, including arms, legs, abdomen and breasts. It is very important in these patients to assess the surgical risks as some of them also have diabetes, hypertension and heart disease that may limit their ability to undergo combined procedures.
“Prolonged operating time increases the risks of serious complications such as blood clots, lung problems and fluid shifts, and safety is always our primary concern,” Dr. Papay says.
One of the positive aspects of the extreme makeover shows is that they have prompted some patients to request evaluations of their whole body, not just a particular part. “I think it more socially acceptable now to talk about multiple issues,” he notes.
Dr. Papay says he enjoys combining multiple surgical procedures for appropriate patients as long as safety is not compromised because “these are some of the happiest plastic surgery patients we have.”
